Key Points 1. Structural heart disease intervention is a rapidly growing field that has expanded beyond transcatheter aortic valve implantation to include procedures that address each cardiac valve, as well as paravalvular leak, intracardiac shunts, and left atrial appendage occlusion…
Key Points 1. Mechanical circulatory support (MCS) for the failing heart has become a mainstay of the modern management of patients with both acute and chronic heart failure (HF) refractory to pharmacologic and other usual interventions. 2. Outcomes with MCS…
Key Points 1. Chronic thromboembolic pulmonary hypertension (CTEPH) results from incomplete resolution of a pulmonary embolus (PE) or from recurrent PEs. It is an underappreciated phenomenon and incidence is difficult to estimate. 2. The cause of CTEPH after acute PE…
Key Points 1. Lung transplantation is a palliative procedure that provides a significant survival benefit for the appropriate candidates. 2. Primary graft dysfunction is the major cause of early morbidity and mortality after lung transplantation. 3. There are four types…
Key Points 1. Cardiac transplantation provides significant survival benefit for appropriate candidates and is superior to ventricular assist device implantation alone. 2. Primary graft dysfunction is a major cause of early morbidity and mortality after heart transplantation. 3. Donation after…
Key Points 1. Patients with uncommon cardiac diseases frequently have complicated medical conditions, the treatment for which should take place in the context of an institution capable of providing coordinated multidisciplinary perioperative care. 2. A cardiac mass is more likely…
Key Points 1. Comprehensive preoperative, intraoperative, and postoperative care of the adult with congenital heart disease (ACHD) requires a solid understanding of the most common congenital heart defects and the reparative and palliative procedures used to treat them. 2. The…
Key Points 1. Although various valvular lesions generate different physiologic changes, all valvular heart disease is characterized by abnormalities of ventricular loading. Changes in atrial pressure and volume are now recognized in valvular pathologies as well. 2. The left ventricle…
Key Points 1. Anesthesiologists are part of a multidisciplinary patient management team. 2. Updated guidelines identify appropriate indications for coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) in patients with multivessel or left main coronary artery disease (CAD).…
Key Points 1. Monitoring the effect of heparin is done using the activated clotting time (ACT), a functional test of heparin anticoagulation. The ACT is susceptible to prolongation because of hypothermia and hemodilution and to reduction because of platelet activation.…